Provider Contracting Director jobs in Illinois

Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director of Payer Contracting
  • OrthoIllinois
  • Elgin, IL FULL_TIME
  • It's the people that make a difference. Are you ready to make your impact? In 2023, OrthoIllinois and Midwest Orthopaedics at RUSH became divisions under a new entity called OrthoMidwest. We are two of the largest independent orthopedic practices in Illinois with locations in western and southern suburbs expanding across southern Wisconsin, Chicago, and northwest Indiana. Each entity is determined to deliver the highest level of dedication, innovation, and quality patient care.

    Primary Duties and Responsibilities:

    • Responsible for the development, coordination, and analysis of payer contracts including commercial, work comp, and government payers.
    • Responsible for overall strategy and execution of alternative payment model reimbursement methods. Including but not limited to Clinically Integrated Networks, ACOs, bundles, and capitation.
    • Proactively negotiates reimbursement terms and language of payer contracts.
    • Responsible for identifying ongoing managed care opportunities including bundled payment arrangements in the marketplace.
    • Responsible for developing employer direct pricing strategies.
    • Collaborates with OrthoComplete Business Development Managers regarding the employer direct contracting strategy.
    • Responsible for setting group practice and ambulatory surgery center chargemaster methodology. Validates consistent chargemasters across divisions.
    • Manages the planning process for contract renewals and negotiations including data analysis to substantiate contract proposals and counter proposals.
    • Monitors and analyzes performance of third party payer agreements (including commercial, work comp, and government) for profitability, volume, strategic initiatives, and payer compliance issues.
    • Collaborates with divisional Business Office staff and acts as a point of contact for resolution when payer issues arise related to provider enrollment.
    • Responsible for management of a third party payer enrollment team in collaboration with divisional credentialing departments.

    Competencies:

    • Leadership: Leads team to success by defining clear expectations, utilizing individual and shared strengths, while providing feedback for improvement and recognizing success; holds team accountable, and redirects group efforts to effectively meet organizational needs.
    • Strategic Agility: Ability to continuously adjust and adapt, to achieve a competitive advantage
    • Business Acumen: Ability to plan through strategic thinking; an understanding of all areas of a business' operations and how they are interconnected as well as the market landscape and competition; recognition of the financial elements of the business; and making decisions to maneuver a business through appropriate strategy
    • Collaboration: Demonstrates cooperation and teamwork working towards solutions that generally benefits all involved parties.
    • Communication: Actively listens, interprets verbal and nonverbal cues, and seeks to understand; presents information clearly both verbally and written with the goal to inform and care for patients; able to adjust presentation as needed for audience
    • Decision Making: Collects and reviews relevant data before acting balancing risk and rewards of options, encourages input from other subject matter experts, able to adjust opinions and recommendations based on new information, and objectively evaluates decisions after they have been made


    Organizational Culture:

    All OrthoMidwest employees focus on service by putting the mission, vision, and value statements into practice and using the guiding principles of Compassion, Respect, Trust, Integrity, Innovation, Education, Fiscal Responsibility, Practice Independence, Accountability, and Empowerment to direct their interactions and decision making. Employees promote and model the service standards to create lasting impressions, extraordinary moments, exceptional on-stage experiences, and meaningful and compassionate connections

    Education and Experience Requirements:

    • Master’s degree in Finance, Accounting, Healthcare or related field from an accredited college or university
    • A minimum of five years of experience in a similar position and/or performing similar tasks
    • Prior experience working for local or national health insurance companies, preferred
    • A minimum of four years of experience managing people
    • Expert working knowledge of Microsoft and Google suites

    Environmental/Working Conditions:
    Working environment is in an office/clinic setting. Occasional work hours outside of normal business hours, including evening and weekends.

    Physical/Mental Demands

    • Sit for extended periods of time.
    • Requires lifting, carrying and/or moving objects in a manner consistent with most office environments (generally, no more than 10 pounds on a frequent basis and 20 pounds on an occasional basis).
    • Finger dexterity for typing on a keyboard and using a mouse for extended periods of time.
    • Vision (e.g., depth perception, color vision, strong vision up close); hearing (e.g., high pitch sounds, soft or distant sounds).

    This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

    Our employees make the difference in our patients’ lives, and we value their contributions. OrthoMidwest offers a comprehensive compensation and benefits package and an opportunity to grow and develop your career with an industry leader. Come see what we’re all about. Equal Opportunity Employer.

    Education

    Required
    • Masters or better
  • 21 Days Ago

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Director of Payor Contracting
  • Elite Dental Partners
  • Chicago, IL FULL_TIME
  • JOB SUMMARY The Director of Payor Contracting is a key leadership role responsible for developing, negotiating, and managing contracts with healthcare payors, including insurance companies, government...
  • 23 Days Ago

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Director of Payer Contracting
  • Midwest Orthopaedics at RUSH
  • Westchester, IL FULL_TIME
  • It's the people that make a difference. Are you ready to make your impact? In 2023, OrthoIllinois and Midwest Orthopaedics at RUSH became divisions under a new entity called OrthoMidwest. We are two o...
  • 1 Month Ago

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Director, Contracting & Payor Relations
  • Athletico Physical Therapy
  • Brook, IL FULL_TIME
  • Position Overview Greater Purpose and Core Values: Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cos...
  • 2 Months Ago

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Manager Payor Provider Contracting Managed Care
  • USA Clinics Group
  • Lincolnshire, IL CONTRACTOR,FULL_TIME
  • The Manager Payor Provider Contracting Managed Care will provide strategic direction for and oversight of all managed care network development activities, oversee negotiation of all managed care contr...
  • 8 Days Ago

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National Director, Contracting & Payer Relations
  • Athletico Physical Therapy
  • Brook, IL FULL_TIME
  • Position Overview Greater Purpose and Core Values: Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cos...
  • 2 Months Ago

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Logistics Provisioner Army Project
  • Conley & Associates, Inc
  • Harvey, LA
  • Job Description Job Description Job Description: Work in Powerlog creating a database as directed. Screen parts and comp...
  • 3/28/2024 12:00:00 AM

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Assistant Accountant (Provisional)
  • City of Buffalo, NY
  • Buffalo, NY
  • An incumbent to a position in this class performs professional accounting work of more than ordinary difficulty in maint...
  • 3/28/2024 12:00:00 AM

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Provisional Licensed Counselor
  • Christian Wellness Center Of NJ LLC
  • Somerset, NJ
  • Job Description Job Description Duties/Responsibilities: • Provide counseling for clients and patients, individually and...
  • 3/28/2024 12:00:00 AM

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Provisionally Licensed Clinician, LAC, LSW
  • Human Institute
  • Totowa, NJ
  • HUMAN INSTITUTE PSYCHOLOGY AND THERAPY Provisionally Licensed Clinician, LAC, LSW $35 to $45/hr Full-time or Part-time C...
  • 3/28/2024 12:00:00 AM

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Payroll Specialist (Provisional) CBO
  • Wayne-Finger Lakes BOCES
  • Newark, NY
  • Regional Support Center - Central Business Office $48,000-$60,000 This is a competitive position. Must meet requirements...
  • 3/27/2024 12:00:00 AM

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Clerk, Bilingual (Spanish) Provisional 10/23
  • Inc. Village of Hempstead
  • Hempstead, NY
  • The Village of Hempstead is seeking a candidate to be the Front Desk Receptionist who will provide information to the pu...
  • 3/27/2024 12:00:00 AM

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CNA/LPN On-call Provisional
  • College of St Benedict/St Johns University
  • Collegeville, MN
  • Position Summary Saint John's Abbey invites applications for the on-call positions of CNA and LPN in the Abbey Retiremen...
  • 3/24/2024 12:00:00 AM

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Licensed Psychotherapist ( Provisional or Fully Licensed)
  • Clinical Counseling and Consulting
  • Fayetteville, NC
  • Job Description Job Description We are seeking a Licensed Psychotherapist ( Provisional Or Fully Licensed) to join our t...
  • 3/24/2024 12:00:00 AM

Illinois (/ˌɪlɪˈnɔɪ/ (listen) IL-ih-NOY) is a state in the Midwestern and Great Lakes region of the United States. It has the fifth largest gross domestic product (GDP), the sixth largest population, and the 25th largest land area of all U.S. states. Illinois is often noted as a microcosm of the entire United States. With Chicago in northeastern Illinois, small industrial cities and immense agricultural productivity in the north and center of the state, and natural resources such as coal, timber, and petroleum in the south, Illinois has a diverse economic base, and is a major transportation hu...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$176,857 to $255,430

Provider Contracting Director in New Suffolk, NY
The partners expect that their efforts toward greater collaboration between mutuelles and private providers will contribute to greater financial risk protection of covered citizens and support access to universal health coverage.
January 02, 2020
Provider Contracting Director in Vincennes, IN
The provider of services can choose how to perform the service.
January 27, 2020
Provider Contracting Director in Wichita Falls, TX
The Credentialing Committee is chaired by our Medical Director and they give the final determination if a provider meets our credentialing criteria.
December 05, 2019